Clonazepam (clonazepam)

Dosage of clonazepam must be carefully and slowly adjusted according to individual requirements and response. Clonazepam should be withdrawn slowly, and abrupt discontinuance of the drug should be avoided, especially during long-term, high-dose therapy to avoid precipitating seizures, status epilepticus, or withdrawal symptoms. If clonazepam is to be discontinued in patients who have received prolonged therapy with the drug, it is recommended that dosage be tapered gradually. Addiction-prone patients (e.g., alcoholic patients, individuals known to have been dependent on other drugs) should be carefully monitored while receiving clonazepam or other psychotropic therapy because of the predisposition of these patients to habituation and addiction. During clonazepam withdrawal, simultaneous substitution of another anticonvulsant may be indicated.

The effect of renal impairment on clonazepam elimination is not known.

The possibility that clonazepam dosage adjustment may be necessary in patients with hepatic impairment should be considered.

Clonazepam is administered orally.

Clonazepam conventional tablets should be administered with water and swallowed whole. The orally disintegrating tablets should be administered immediately after opening the pouch and peeling back the blister; do not push the tablet through the foil. The orally disintegrating tablet should be removed with a dry hand and placed on the tongue, where it disintegrates rapidly in saliva, and then subsequently can be swallowed with or without water.

In the treatment of seizure disorders, the manufacturer states that daily dosage usually is given in 3 equally divided doses. The largest dose should be given at bedtime if doses are not equally divided.

In the treatment of panic disorder, the daily dosage of clonazepam may be given in 2 equally divided doses. Alternatively, the drug may be given as one dose at bedtime to reduce the inconvenience of somnolence.

Clonazepam also has been administered IV+, but a parenteral dosage form is not currently commercially available in the US.

Patients who are currently receiving or beginning therapy with clonazepam and/or any other anticonvulsant for any indication should be closely monitored for the emergence or worsening of depression, suicidal thoughts or behavior (suicidality), and/or any unusual changes in mood or behavior. (See Cautions: CNS Effects and Cautions: Precautions and Contraindications, in the Anticonvulsants General Statement 28:12.)

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Safe use of clonazepam during pregnancy has not been established. Adverse fetal effects have been observed in reproduction studies in rats and rabbits. Although several reports suggest an association between use of anticonvulsants in pregnant, epileptic women and an increased incidence of birth defects in children born to these women, a causal relationship to many of these drugs has not been established. The manufacturer states that the majority of women receiving anticonvulsant therapy deliver normal infants. Clonazepam should be used in pregnant women or women who might become pregnant only if the drug is considered essential in the management of their seizures. Anticonvulsants should not be discontinued in pregnant women in whom the drugs are administered to prevent major seizures because of the strong possibility of precipitating status epilepticus with attendant hypoxia and threat to life. In individual cases, when the severity and frequency of the seizure disorder are such that discontinuance of therapy does not pose a serious threat to the patient, discontinuance of the drugs may be considered prior to and during pregnancy; however, it cannot be said with any certainty that even minor seizures do not pose some hazard to the fetus. The clinician should carefully weigh these considerations in treating or counseling epileptic women of childbearing potential.

Safe use of clonazepam during lactation has not been established. The manufacturer states that it is inadvisable for women receiving clonazepam to nurse infants.

No enhanced messaging available.